内镜综合性内外科手术与皮肤性瘤切除术:匹配病例对照分析的结果
Rodrigo Perrella1,2, Fabio Carvalho Vicentini3,4, Matheus Marques P Neto5
1Division of Urology, Military Hospital of Sao Paulo, Sao Paulo, Brazil. perrella.uro@gmail.com.
World journal of urology
|May 6, 2025
概括
内镜联合内外科手术 (ECIRS) 对结石的成功率更高,特别是复杂的结石,与皮肤结石切除术 (PCNL) 相比. 这两种手术在本研究中都显示出相似的并发症率.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 腎石病的治療方法
背景情况:
- 结石对健康造成重大负担,需要有效的治疗选择.
- 穿皮瘤切除术 (PCNL) 是一种标准治疗方法,但其在复杂病例中的疗效可能有限.
- 内镜综合内手术 (ECIRS) 是一种新兴的石头去除技术.
研究的目的:
- 为了比较内镜综合内外科手术 (ECIRS) 与皮肤瘤切除术 (PCNL) 的疗效和安全性.
- 评估结石治疗结果,重点关注无结石率和并发症.
- 评估ECIRS在治疗复杂和大型结石方面的有效性.
主要方法:
- 一项追溯匹配病例控制研究,涉及165名患者 (55名ECIRS,110名PCNL).
- 根据使用Guy's Stone Score (GSS) 的石头复杂性,患者与1:2匹配.
- 手术后90天通过CT评估了无结石率;分析了并发症和其他变量.
主要成果:
- 与PCNL (56.4%;p=0.001) 相比,ECIRS的无石率 (81.8%) 显著更高.
- 对于复杂的石头 (GSS 3-4),ECIRS特别有效,其无石头率更高 (79.2%对41.7%;p=0.003).
- 在ECIRS (21.8%) 和PCNL (26.4%;p=0.607) 之间没有观察到并发症率的显著差异.
结论:
- 内镜联合内手术 (ECIRS) 在实现结石,特别是复杂结石的无石头状态方面表现出卓越的疗效.
- ECIRS提供与PCNL相似的安全概况,并具有类似的并发症率.
- ECIRS代表了治疗大型和复杂结石的有效替代方案.
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